Finding the surgeon

The first step is to find a surgeon that can do your surgery. You can check out the World Professional Association of Transgender Health (WPATH) provider directory to find a surgeon near you.

Depending on the type of surgery, some surgeons and insurance companies might require you to have been on GAHT for at least a year, but this is not always a requirement. Once you know the timeline for your surgery, just let us know. You will need to verify with your surgeon and/or insurance company that a letter from a medical provider is sufficient. Please confirm that they are not seeking a letter from a mental health provider. This is an important distinction, so check with your surgical team to be on the safe side!

For masculinizing surgeries 

For feminizing surgeries

NOTE: The websites cited above are intended to be a resource to gather information, and Plume does not personally endorse these websites nor the providers listed in their directories.

Getting the letter

In order to complete your letter of support for your surgery, your care team will need to know the following information from you.

  • Date (month and year) you started GAHT (gender-affirming hormone therapy, sometimes called HRT) 

  • Date (month and year) you started socially identifying as trans or non-binary

  • Which surgical procedure(s) are you planning?

  • The date you need the letter completed by

At this time, we do not provide mental health letters of support. Sometimes your insurance company or surgeon may ask to see both a medical provider letter of support and a mental health provider. We at Plume are more than happy to provide a medical provider letter of support, but are unable to provide mental health letters of support from a licensed therapist. However, you can get a mental health letter of support for free from some therapists. The Gender-Affirming Letter Access Project (GALAP) is a list of helpful therapists. 

While it is not always required, sometimes your surgeon may ask for a letter of medical clearance before surgery. This is to ensure that you are medically stable to undergo the procedure. If required, this letter cannot be completed by your Plume provider as it requires an in-office visit. It will need to be completed by your primary care provider. Ask your surgeon’s office for more information on their specific pre-surgery requirements.